Pain Management

  • Approximately 116 million Americans suffer from chronic pain – more than the number of people affected by diabetes, heart disease, and cancer combined;
  • The over prescribing of opiods in the treatment of painful medical disorders including arthritis, headache, lower back pain and other musculoskeletal illnesses is a major cause of Opioid Addiction
  • However: For documented and accurately diagnosed pain, opioids do not increase the risk of addiction.
  • The over prescribing of benzodiazepines and sleep medications for anxiety and insomnia associated with painful medical illnesses often result in substance use disorders to these medications.MP900285034
  • Opioids are among the most effective medication available for managing pain in medicine today. They are also the most widely abused.
  • The paradox is that sometimes the dependency on Opioid Pain-killers for a pain condition is a factor leading to chronic pain syndromes.

Opioids for Pain vs. Opioids in Addiction
Below is a chart showing the Clinical Features of a patient Addicted to Opioids and one that is not addicted to Opioids–or taking it for pain management. Note the difference of the two.

Clinical Features

Patients With Pain

Patients Addicted to Opioids

Compulsive drug useRareCommon
Crave drug (when not in pain)RareCommon
Obtain or purchase drugs from nonmedical sourcesRareCommon
Procure drugs through illegal activitiesAbsentCommon
Escalate opioid dose without medical instructionRareCommon
Supplement with other opioid drugsUnusualFrequent
Demand specific opioid agentRareCommon
Can stop use when effective alternate treatments are availableUsuallyUsually not
Prefer specific routes of administrationNoYes
Can regulate use according to supplyYesNo

Illness/Injury in Substance Use Disorder -SUD- Patients: Prescribing Opioids
The problem: Opioid Pain Medications are often not properly prescribed to patients who have a history of Alcohol or Substance Use Disorders out of fear of “feeding the addiction” or of ”triggering relapse” in abstinent patients.

ARCH Addiction Psychiatrists believe that our patients who experience pain from illness or injury can be safely treated within the context of their medical or surgical care.

Appropriate treatment minimizes the risks associated with acute and chronic pain such as:

  • Suboptimal pain management;
  • Poor medical care;
  • Overdose and drug associated suicide;
  • Poor short and long term recovery outcomes;
  • Relapse.

ARCH Addiction Psychiatrists Coordinate Care With:

  • Medical specialists who are treating the underlying medical and disorders that cause painful conditions;
  • Doctors who specialize in Chronic Pain Management.

ARCH Diagnosis & Treatment
ARCH’s evaluation begins with a thorough Comprehensive Diagnostic Assessment led by our Addiction Psychiatrists focusing on diagnosing co-occurring medical disorders commonly associated with chronic pain syndromes and with Substance Use Disorders (SUD). Our patients will:

  • Be interviewed by our Psychologists and/or Behavioral Therapist who are evaluating psychological problem that complicate chronic pain syndromes;
  • Complete a series of tests that evaluate perceptions and attitudes to pain and the possible role of psychiatric factors contributing to the problem;
  • Complete Diagnostic Laboratory Tests helpful in diagnosing medical disorders associated with addiction or co-occurring psychiatric illness;
  • Have an Individualized Recovery Plan based on their addiction and pain problems.

Please call us in Danvers:

(978) 820-5500

Dr. Michael J. Kittay, M.D.
160 Sylvan Street, Danvers, MA 01923
Phone. (978) 820-5500
Fax. 978-820-5502

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